Charles Gaba's blog

via Wikipedia:

Medicare Advantage (technically "Medicare Part C" & originally called "Medicare+Choice") is a type of health plan in the United States offered by private companies as part of the original Social Security Act of 1965 that created Medicare. It permits a private insurance option that wraps around traditional Medicare. Medicare Advantage plans attempt to fill some coverage gaps and offer alternative coverage options.

Under Part C, Medicare pays a plan operator a fixed payment for each enrollee. The operator then pays for their medical expenses. Traditional Medicare directly compensates providers on a fee-for-service basis. Plans are offered by integrated health delivery systems, labor unions, non profit charities, and health insurance companies, which may limit enrollment to specific groups of people (such as union members).

Once again: The true measure of ACA healthcare coverage enrollment isn't how many people select policies during the Open Enrollment Period, it's how many actually have those policies in effect (aka "effectuated enrollment")...as well as how comprehensive that coverage is, of course.

Yesterday, Pluribus News published a new story about effectuated enrollment across a dozen or so states (the reporters actually consulted with me several times about their data and how to present it, although I somehow didn't end up getting credited in the final version).

In any event, most of the material discussed in their story is pretty much everything I've been writing about and warning about for months, and even the enrollment data they acquired is the same as what I have in most cases. They were, however, able to get ahold of hard effectuation numbers for three states which I didn't already know: Arkansas, Nevada and Vermont.

Once again: The true measure of ACA healthcare coverage enrollment isn't how many people select policies during the Open Enrollment Period, it's how many actually have those policies in effect (aka "effectuated enrollment")...as well as how comprehensive that coverage is, of course.

Yesterday, Pluribus News published a new story about effectuated enrollment across a dozen or so states (the reporters actually consulted with me several times about their data and how to present it, although I somehow didn't end up getting credited in the final version).

In any event, most of the material discussed in their story is pretty much everything I've been writing about and warning about for months, and even the enrollment data they acquired is the same as what I have in most cases. They were, however, able to get ahold of hard effectuation numbers for three states which I didn't already know: Arkansas, Nevada and Vermont.

Here's some more Arkansas data on top of yesterday's analysis of premium & out of pocket cost increases.

Once again: The true measure of ACA healthcare coverage enrollment isn't how many people select policies during the Open Enrollment Period, it's how many actually have those policies in effect (aka "effectuated enrollment")...as well as how comprehensive that coverage is, of course.

Yesterday, Pluribus News published a new story about effectuated enrollment across a dozen or so states (the reporters actually consulted with me several times about their data and how to present it, although I somehow didn't end up getting credited in the final version).

And the hits just keep on coming: Via The Oregonian:

Providence to end most health insurance plans, forcing hundreds of thousands in Oregon to switch

Providence Health & Services plans to exit most of its Oregon health insurance business next year, citing rising costs, tougher regulation and intensifying competition from national insurers — a move that will force hundreds of thousands of Oregonians to find new coverage.

Leaders of the Renton, Washington-based health system announced the decision Wednesday, saying Providence will stop offering most plans through Providence Health Plan, including individual, family and employer coverage, as it seeks to strengthen its financial footing and refocus on delivering care rather than operating an insurance arm.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

I've written countless analyses of how much both gross and net premiums skyrocketed from 2025 to 2026 across different states, different income levels and various other demographics...and last week it was revealed that over 3 million ACA exchange enrollees had already been priced out of the market as of April, with the number almost certain to climb further throughout the rest of 2026.

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